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ELKINS HYPNOTIZABILITY SCALE (EHS)

Hypnotic Relaxation Therapy: Principles and Applications

Copyright 2013, Reproduced with the permission of Springer Publishing Company,

LLC, from book: Hypnotic Relaxation Therapy: Principles and Applications,

Springer Publishing Co., ISBN: 9780826199393

Gary Elkins Ph.D., ABPP, ABPH

Protocol for Administration

Introductory Remarks (Note: Ensure that the subject is seated in a comfortable chair

with support for their head, neck and shoulders. A foot-stool may be provided to allow

the subject to elevate their legs, however, if seated in a recliner, the back of the chair

should not be reclined. See the “General Instructions for Administration and Scoring of

the EHS for further information.)

This is a scale to measure your ability to experience hypnosis and respond to hypnotic

suggestions. It is a standardized scale and therefore I will be reading from these papers.

You may occasionally hear me writing or hear the sound of things outside this room.

You can pay as much or as little attention to such sounds as you wish. The best way to

determine a person’s ability to experience hypnosis is to complete a hypnotic induction.

This will involve focusing your attention on a spot on the ceiling and suggestions for

calmness. After your eyes close I will give you some hypnotic suggestions. It is

important to just respond to what you are feeling and experiencing. There is nothing that

you have to try to do, just allow yourself to respond to whatever you experience. Not

everyone experiences the same things and not everyone is equally hypnotizable. At times

during hypnosis I will ask you to verbally describe what you are feeling or experiencing.

You will be able to do so without interrupting your experience of hypnosis. As you listen

to my words just let whatever happens happen so that we can see how you experience

hypnosis and how we can learn to make hypnosis work best for you.

(Note: Place a small table (with a white top) in front of participant before beginning

the induction. Ask the participant to extend their arms and bring them down to a

relaxed position on the arms of the chair.)

Induction Now, please roll your eyes upward and focus on a spot on the ceiling. That’s right. Now,

focus on that spot so intently . . . that everything else begins to fade into the background .

. . more and more . . . Good. Now take a breath of air and hold it for a moment . . . hold .

. . and as you exhale allow your eyes-lids to close normally and naturally. . . Good . . .

Now, allow your body to relax. . . Notice a wave relaxation spreading from the top of

your head . . . down to your feet. . . Letting all the tension go . . . Head, neck , shoulders .

. . relax . . . arms and legs.. relax . . . As you enter a hypnotic state finding a calm . . .

relaxed feeling. More calm and more at ease . . . comfortable and calm . . .

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Now, as I count from the number ten down to one, with each number that I count . . .

going into an even deeper state of hypnosis.

(Note: During the deepening suggestions, numbers are counted on the subject’s

exhalation.)

10 . . . A wave of relaxation spreading across your forehead . . . neck . . . and

shoulders.

9 . . . More relaxed . . . your jaw goes slack . . . shoulders slump . . . and arms

become very relaxed.

8 . . . That wave of relaxation now spreads across your back . . . Your upper back . .

. and lower back . . . deeply relaxed.

7 . . . A deeper level of hypnosis now as your legs become very relaxed, letting all

the tension go . . . feeling more calm . . . feeling more peaceful.

6 . . . Entering such a deep level of hypnosis now . . . that you may notice a drifting

or floating sensation . . . just drifting . . . and floating . . . deeper and deeper into

this hypnotic state. . .

5 . . . Deeply calm and deeply hypnotized. . .

4 . . . Now allowing that calmness to become even more complete . . . and entering

the deepest level of hypnosis. . .

3 . . . So deeply hypnotized that you are able to respond to each suggestion . . . and

experience each thing that I suggest. . .

2 . . . Calm and peaceful . . . so deeply relaxed. . . any tension that has remained is

released. . . now. . .

1 . . . All the way there. . . deeply hypnotized. . . calm and peaceful. . .

and it is possible to feel a special sense of calmness. . . and you will be able to experience

and respond to each suggestion during hypnosis today. . . Just listen to my voice and let

whatever happens happen so we can see how you experience hypnosis. . . .

Arm Heaviness/Immobilization Now as you remain deeply calm . . . you will soon become aware of a change in

sensation in your right arm and hand. . . Soon you will notice that your right arm will

become very, very heavy . . . just as heavy as lead . . . that heavy feeling begins to occur

now . . . that arm becomes heavier and heavier . . . and as this occurs it can feel as if the

arm were becoming less a part of you . . . as you allow it to become as heavy as lead.

(pause for five seconds)

And now that arm will become even heavier . . . so very heavy that you will find that you

cannot lift this right arm . . . no matter how hard you try to raise it . . . it will be too heavy

to lift . . . and finding that you just don’t want to lift it, in fact . . . the harder you try, the

heavier the arm and hand will become . . . and now the arm, the wrist, the hand and even

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the fingers have become stuck to the chair . . . They just won’t move . . . they are so very

heavy.

(pause for five seconds.)

Now . . . as this hand and arm remain as heavy as lead and too heavy to lift, I want you,

in a moment, to try to lift them, but they will not move . . . the arm, the wrist, the hand

and even the fingers are stuck to the chair and too heavy to move. Go ahead and try to

lift them, genuinely try, but they are just stuck to the chair and they are too heavy.

(Pause for 5 Seconds.)

Very good. Now allow your arm to relax, this heavy feeling passes and the right hand

and arm rest. . . Normal sensation returns . . . and as this occurs going into an even deeper

level of hypnosis.

Record Observations :

1. Did the arm lift?

2. Was there obvious effort to lift the hand and arm?

3. Other observations (Note finger movements etc.)

Arm Levitation

Now as you go into an even deeper level of hypnosis . . . you will soon become aware of

a change in sensation in your left arm and hand . . . Soon you will notice that your left

arm and hand will become very, very light . . . and weightless . . . just as light as a feather

. . . that light feeling begins to occur . . . now . . . it becomes lighter and lighter . . . and as

this occurs it can feel as if the arm were becoming less a part of you . . . as you allow it

to become so . . . light and weightless.

(Pause for 5 seconds.)

And now . . . there is a ribbon around the left wrist . . . and at the other end of that ribbon

are several balloons . . .red, yellow, green, blue…all different colors… There are quite a

few of them . . . four or five balloons . . . and these balloons are lighter than air and they

begin to float upward . . . . . . and as they do . . . the left hand begins to float upward . .

.Just notice the balloons are tugging . . . pulling . . . lifting the wrist up . . . up . . . up . . .

it just drifts and floats up . . . feeling lighter and lighter . . . Floating up higher and higher

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. . . Just allowing the arm to float up . . . all by itself . . . just as high as it wants to go . . .

Floating up now. . . higher and higher.

(Pause for 5 seconds for the response to occur; wait until levitation stops)

Very good. Now this feeling passes and your hand and arm begin to drift downward to

its comfortable resting position . . . (Wait for the arm to begin to lower, additional

suggestions for normal sensations and arm lowering may be given) The balloons are

gone . . . Normal sensation returns to your arm and hand and as this occurs going into an

even deeper level of hypnosis. (If the arm remains lifted, instruct the participant to lower

the arm to the chair.)

Record Observations.

1. Did hand or arm lift?

2. Was there obvious effort to raise the arm and hand?

3. Did the elbow raise from the arm of the chair?

4. Other observations.

Imagery Involvement/Dissociation And now something very interesting is going to happen . . . It is possible to hear my voice

with one part of your mind . . . and with another part of your mind . . . to find that you

will feel as if you are in a different place . . . Soon you will find that you can feel as if

you are no longer in this room and instead you will experience being in a beautiful flower

garden. . . And when this occurs, you will be able to see everything there . . . You will

experience every sight . . . sound, smell . . . and feeling in this garden . . . When this

occurs you will find that . . . you feel as if you are no longer in (state present place) and

instead you will, experience being in a flower garden experiencing everything there . . .

Now, as you hear my voice, at the same time seeing before you a gate that leads into the

flower garden . . . Seeing the gate now . . . and as I count from one to four you will find

that you are walking through that gate and into the flower garden . . . more than just

imagining it . . . soon you will be in a flower garden . . . walking through the garden.

One . . . Going though the gate now . . .

Two . . . As you go into the garden you can see the flowers that are there. . .

Three . . . able to continue to hear my voice as you are there . . . experiencing

every sight, sound, smell and feeling in this flower garden . . .

Four . . . now you are there . . you are in a flower garden . . .

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(Pause for 5 seconds and then proceed.)

Good. It is a warm day . . . and yet you can feel a gentle cool breeze in the air . . . It is

very pleasant . . . Feeling safe, secure and relaxed . . . Before you is a path. As you walk

down this path notice that there are flowers all along the path. The grass is very green

and there are many beautiful flowers. Now, notice the colors of the flowers . . . whether

you see red, yellow or any other colors.

There . . . There is a very beautiful red rose . . . You can see this rose . . . Now, stopping

there for a moment . . . go close enough to smell the wonderful sweet aroma of this

beautiful rose . . . The aroma of the rose becomes stronger now . . . it is a pleasant smell .

. . now take a breath and . . . Just smell the rose . . . and notice how strong the smell is . . .

(Pause for 5 seconds)

Now . . . as you are there . . . you can describe what you are experiencing without

interrupting your experience of hypnosis. Please describe what you are experiencing

(If the subject does not respond the first question; prompt with. . .“You can answer

verbally . . .etc.” Record responses to each question.)

Where are you?

What do you see around

you?

Do you see the rose?

Do you smell the rose?

Other comments:

Very good . . . Now, soon returning back to this room at (state present place) and the

present time . . . as you remain deeply hypnotized . . . Now walking back through that

gate and returning to the present time and back to (state present place) . . . You are now

here deeply hypnotized and comfortably experiencing hypnosis. . .

Positive Hallucination

And now . . . going into an even deeper state of hypnosis . . . In fact, going very deeply

hypnotized and very deeply calm . . . Good . . .

Now, in a few moments I will ask you to open your eyes as you continue to remain in a

deep state of hypnosis . . . When you open your eyes you will see a small blue block on

the table in front of you . . . A little square block . . . The kind of block that a child might

play with . . . The block is bright blue . . .

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In order for you to be able to see the block on the table it may be helpful to first see it in

your mind before you open your eyes. . . . A little blue block . . . sitting on the table . . .

The kind of block a child might play with . . . Just really see it in your mind . . . and, in a

moment, when you open your eyes you will see the block on the table.

(Pause for five seconds.)

All right . . .now, as I count from one to three, I will ask you to open your eyes . . . You

will remain deeply hypnotized and you will see a small blue block on the table in front of

you.

Some people see the block right away, while others see more of a blue color, . . . a shape

or shadow at first.

One . . . beginning to open your eyes

Two . . .eyelids opening

Three . . . eyes open now . . .

Now, look at the table in front of you . . . Just continue looking . . . and notice what you

see on the table . . . just really looking . . . and noticing . . .whatever you see there . . .

(Note responses to each question.)

What do you see on the table?

(Inquire as needed: Do you see the

block?)

If the subject does not report seeing the block, inquire further

If no description of a block,

inquire as needed to determine if

there is any perception of a color,

shape or shadow etc.: Do you see

anything on the table? Do you see

any color, shape or shadow of a

block? (Note detail of any

evidence of a positive

hallucination such as a color, shape

or shadow etc.)

(Note: If no perception of a block is reported, then add, “Not everyone sees something

on the table.” and proceed as below.)

Very good . . . Now allow your eyelids to close and go into an even deeper state of

hypnosis . . . relaxing deeply and feeling calm and relaxed . . .

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Post-Hypnotic Amnesia Now, while remaining in a deep state of hypnosis . . . you can hear my voice and all of

the suggestions that I give to you. In a few moments I will suggest that you return to

conscious alertness. However, when you return to alertness you will find that…you are

not able to recall any of the things that happened . . .during the hypnosis session today. . .

You have been so deeply absorbed in experiencing hypnosis that you will have a great

deal of difficulty in recalling any of the suggestions I gave you and the things you

experienced . . . In fact, the harder you try the more difficult it will be to recall these

things . . . It will be much easier to just forget . . . you will not be able to recall anything

about the hypnosis session today . . . It will seem like there is a wall between you and the

memory . . . Just allow this to occur . . . so that the wall is there now . . . and you will

find that you just don’t want to remember at all. You will not be able to recall anything

that happened during hypnosis today until you hear me say these words,

“Now you can recall everything.”

Then the wall will lift and then you will be able to recall all of your experiences . . . Now,

as I count from one to ten you will return to alertness . . .

Alerting All right, returning to conscious alertness now. (Note: increase volume of voice as

counting).

1, 2, 3 beginning to return to conscious alertness.

4, 5 more alert and eyes beginning to open.

6, 7 eyelids opening and returning to alertness.

8, 9 . . . alert and refreshed.

And 10 . . . fully alert.

Do you feel alert? . . . Good. (Note, assure that the subject reports alertness before

proceeding with the Post-Hypnotic Scoring Inquiry.)

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Post Hypnotic Scoring Inquiry

Post Hypnotic Amnesia Scoring Inquiry

I want to ask you a few questions about your experience. Please tell me what you can

recall about what happened during our session today. What do you remember?

(Record the subjects responses. Ask, “anything else” until the subject reaches an

impasse.)

Item Detail

Arm Heaviness

Arm Levitation

Dissociation/Imagery

Positive Hallucination

Post-Hypnotic Amnesia

Amnesia Item Scoring

0 if the subject recalls more than 1 item

1 if the subject recalls 1 item or less

Now listen carefully to what I am going to say next. “Now you can recall everything.”

What do you recall now? Record responses:

Arm Heaviness Arm Levitation Dissociation / Imagery

Positive Hallucination Suggestion for Post Hypnotic Amnesia

(Note: The rose/olfactory hallucination is included as part of the Dissociation / Imagery

and is not a separate item for post-hypnotic amnesia scoring.)

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Arm Heaviness / Immobilization Scoring Inquiry

Earlier I suggested to you that your right arm and hand would feel heavy and then I

suggested that they would be too heavy to lift. I want to find out what your experience

was.

Item Detail

When I suggested that your right arm and hand would feel heavy; did

you feel a sense of heaviness in your right arm and hand? Did they feel

heavier? (Determine if subject experienced any feeling of heaviness.)

Yes

No

(If the hand/arm did not lift, ask) Did you try to lift your hand and arm?

Determine if there was effort to lift the hand and arm. Were they too

heavy to lift? Did they feel stuck to the chair?

Yes

No

Did the subject’s hand and arm remain immobile and “stuck” to the

chair? Review previous observations to determine if the subject’s hand

and arm remained on the chair with just minimal, temporary movements.

Inquire as needed to determine if arm immobilization occurred. (Note:

small finger movements or temporary slight movements often occur with

successful arm immobilization. Arm immobilization refers to an inability

to lift the hand and arm.)

Yes

No

Arm Heaviness Item Scoring

0 if no heaviness.

1 if the subject reports feeling a subjective sense

of heaviness.

2 Beyond slight movements, the hand and arm

did not lift. Arm immobilization occurred.

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Arm Levitation Scoring Inquiry

Earlier, I asked you to experience a very light and weightless feeling in your left arm and

that the arm would lift all by itself.

Inquiry

Did your arm feel lighter? Even if you arm did not lift, did it feel lighter?

(If the arm lifted, ask) Did it float up all by itself without any willful effort on your part?

(Inquire as needed to clarify the subject’s experience. Determine if the subject

experienced a sense of involuntary lifting. “Could you feel it floating up all by itself or

did you feel like you were lifting it? Did it feel like the balloons were pulling it up?”)

Arm Lightness Item Scoring

0 Score 0 if the answer to the first question is no whether or not the arm lifted.

Score 0 if no subjective description of lightness.

1

Score 1 if the answer to the first question is yes, but the arm did not lift out of its

resting position. (Score 1 if a subjective sense of lightness is reported and the

hand did not lift.)

2

Score 2 if the answer to the second question is yes, and the arm did lift out of its

resting position. (Score 2 if a subjective experience of lightness is described and

there is some movement of the hand from the chair with a subjective description

of an involuntary movement.)

3

Score 3 if the answer to the second question is yes and the elbow lifted. (Score 3

if a subjective experience of lightness is described and there is a movement of

the hand of one inch or more with a subjective description of an involuntary

movement and the elbow lifts.)

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Imagery Involvement/Dissociation Scoring Inquiry

Also, earlier, I asked you to experience going for a walk in a flower garden.

Inquiry

1. Were you able to experience what I suggested or were you just listening to my voice?

(If no imagery or only vague imagery is reported, state “Some people do not experience

clear imagery.”)

2. Did you imagine being in the flower garden? Was the image clear? Could you really

imagine being in a flower garden? (Determine if the subject was able to imagine being

in a garden. Determine if the image was clear or only vague (i.e. colors etc. but no

specific imagery of the flower garden.)

Review the previous observations and the subject’s verbal responses to the questions

presented during the item. Determine if the subjects response to the questions: “Where

are you? What do you see around you?’ indicate that the subject may have experienced

dissociation (i.e. felt that they were actually in the garden).

3. If the subject’s responses suggested possible dissociation, ask: Did you feel that, in a

sense, you were no longer in this room and instead you were actually in a flower

garden, experiencing everything there.

(Determine if the subject experienced an alteration in perception in which they felt that

they were no longer in the room and instead experienced being in a flower garden.

Continue inquiry as necessary to distinguish between questions 2 and 3, i.e. “Did it feel

like you were actually experiencing (insert subjects report of sensations) while you were

in the garden or that you were here and imagining it?”)

Mental Imagery / Dissociation Scoring Inquiry

0 If the answer to the first question is no (no imagery or only vague imagery)

1 If the answer to the second question is yes.(clear imagery but no dissociation)

2 If the answer to the third question is yes. (clear imagery and dissociation)

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Rose Olfactory Hallucination Scoring Inquiry

Now, I also suggested to you that you could smell a rose.

Inquiry

Did you smell the aroma of a rose? Did you actually smell it?

0 If the answer is no. Did not actually smell the rose (even if it was imagined)

1 If the answer is yes. Smell was faint.

2 If the answer is yes. Smell was distinct.

Establish the subjective rating of the intensity of the aroma. Check the subject’s rating of

the aroma: How strong was the aroma? Please rate it as none, faint, or distinct

None Faint Distinct

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Positive Hallucination Scoring Inquiry

Also, earlier, I asked you to experience seeing a small block on the table in front of you.

Inquiry

Did you see anything on the table? (Note: if response is “nothing” repeat that “Some

people do not see anything”)

(If the subject reports any perception, inquire further) Please describe what you saw. Did

you see the block? Please describe it. Did you see anything on the table? If yes, please

describe what you saw. Where was it?

Positive Hallucination Scoring

0 If the subject answers negative to perception.

1

If there is any hallucinated perception. Scoring is lenient (i.e. score

one, if the subject reports perception color, shape, shadow etc.) Note

if the subject reports a vague perception of any hallucination.

2

If the subject reports a clear perception of a block. The block is

described with detail of color and shape. The block was clearly

hallucinated.

Note Detail:

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EHS CODING SUMMARY

Examiner: ________________ Date: _____________________

1. Subjective Heaviness Yes _____ No_____

2. Arm Immobilization Yes _____ No_____

3. Subjective Lightness Yes _____ No_____

4. Arm Levitation Yes _____ No_____

5. Elbow Lift Yes _____ No_____

6. Imagery Yes _____ No_____

7. Dissociation Yes _____ No_____

8. Faint Rose Smell Yes _____ No_____

9. Distinct Rose Smell Yes _____ No_____

10. Recalls One or Less Items Yes _____ No_____

11. Vague Hallucination Yes _____ No_____

12. Clear Hallucination Yes _____ No_____

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EHS SCORING SUMMARY

Examiner: _________________ Date: _____________________

Time to complete EHS:________________

Item Criteria Score

Arm

Heaviness/Immobilization

No heaviness. 0

Subjective report of heaviness. 1

Heaviness. Immobilization occurred. 2

Arm Levitation

No weightlessness. 0

Subjective report of lightness. 1

Subjective report of lightness &

effortless arm levitation. 2

Effortless elbow lift. 3

Imagery Involvement/

Dissociation

No experience - Just listening. 0

Experienced clear imagery, but no

dissociation. 1

Experienced clear imagery, and

dissociation. 2

Rose Olfactory

Hallucination

No experience. 0

Reports mild or moderate smell. 1

Reports strong smell. 2

Amnesia Recalls more than 1 item 0

Recalls 1 item or less 1

Positive Hallucination Negative report. 0

Describes vague hallucination only. 1

Reports clear hallucination of a block. 2

Total

0 – 3 Low

4 – 7 Middle

8 – 11 High

12 Very High